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General NPI Number Information
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NPI Number | 1295682698
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Entity Type | Organization
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Legal Business Name | ROOTED DENTAL STUDIO
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 252 E BROAD ST
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City | ELYRIA
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State | OH
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Zip | 44035-6433
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Country | US
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Telephone | 440-822-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 5480 JACQUELINE LN
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-3888
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Country | US
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Telephone | 440-590-2179
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PUJA KEDIA
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Credential | DDS
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Telephone | 440-590-2179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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